1457389967 NPI number — MICHAEL C THOMAS MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457389967 NPI number — MICHAEL C THOMAS MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

THOMAS

Provider First Name:

MICHAEL

Provider Middle Name:

C

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1457389967

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

09/12/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

356 24TH AVE N

Provider Second Line Business Mailing Address:

SUITE 300

Provider Business Mailing Address City Name:

NASHVILLE

Provider Business Mailing Address State Name:

TN

Provider Business Mailing Address Postal Code:

37203-1514

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

615-292-5722

Provider Business Mailing Address Fax Number:

615-346-6225

Provider First Line Business Practice Location Address:

3901 CENTRAL PIKE

Provider Second Line Business Practice Location Address:

SUITE 555

Provider Business Practice Location Address City Name:

HERMITAGE

Provider Business Practice Location Address State Name:

TN

Provider Business Practice Location Address Postal Code:

37076-3419

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

615-874-9667

Provider Business Practice Location Address Fax Number:

615-871-9682

Provider Enumeration Date:

06/30/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208600000X , with the licence number:  13976MD , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 621278261 . This is a "TN CARE SELECT" identifier . This identifiers is of the category "OTHER".
• Identifier: 621278261 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 3020078 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
• Identifier: 62127826137076A001 . This is a "TRICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 021101458 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".
• Identifier: 125537291831 . This is a "HUMANA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 1740238 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 0056839 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
• Identifier: 007930 . This is a "HEALTHSPRING" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 6212782610002 . This is a "CIGNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 621278261 . This is a "BEECH ST" identifier . This identifiers is of the category "OTHER".
• Identifier: 681009 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".